ObjectivesDomestic violence screening is advocated in some healthcare settings. Evidence that it increases referral to support agencies or improves health outcomes is limited. This study aimed to (1) investigate the proportion of hospital patients reporting domestic violence, (2) describe characteristics and previous hospital attendances of affected patients and (3) assess referrals to an in-house domestic violence advisor from Camden Safety Net.DesignA series of observational studies.SettingThree outpatient clinics at the Royal Free London NHS Foundation Trust.Participants10 158 patients screened for domestic violence in community gynaecology, genitourinary medicine (GUM) and HIV medicine clinics between 1 October 2013 and 30 June 2014. Also 2253 Camden Safety Net referrals over the same period.Main outcome measures(1) Percentage reporting domestic violence by age group gender, ethnicity and clinic. (2) Rates of hospital attendances in the past 3 years for those screening positive and negative. (3) Characteristics, uptake and risk assessment results for hospital in-house domestic violence referrals compared with Camden Safety Net referrals from other sources.ResultsOf the 10 158 patients screened, 57.4% were female with a median age of 30 years. Overall, 7.1% reported ever-experiencing domestic violence, ranging from 5.7% in GUM to 29.4% in HIV services. People screening positive for domestic violence had higher rates of previous emergency department attendances (rate ratio (RR) 1.63, 95% CI 1.09 to 2.48), emergency inpatient admissions (RR 2.27, 95% CI 1.37 to 3.84) and day-case admissions (RR 2.03, 95% CI 1.23 to 3.43) than those screening negative. The 77 hospital referrals to the hospital-based domestic violence advisor during the study period were more likely to be taken up and to be classified as high risk than referrals from elsewhere.ConclusionsSelective screening for domestic violence in high-risk hospital clinic populations has the potential to identify affected patients and promote good uptake of referrals for in-house domestic violence support.
There are opportunities for HIV services to provide psychological support around attitudes associated with unemployment and to help HIV-positive men in particular obtain and remain in work.
We demonstrated that healthier alternatives could be provided in a hospital retail premises without negatively affecting total sales, retailer or customer satisfaction.
Background Data from emergency departments (EDs) in England describe the epidemiology of violent assaults. However, the potential of such data to inform hospitalbased public health interventions remains unknown. Objective To identify determinants of assaults using ED data to inform development of programmes delivered in acute Trusts for reducing assault-related injuries in the community. Methods Data were collected from a large North London acute Trust on assault-related injuries reporting to A&E over 18 months (
IntroductionPeople living with HIV (PLWH) are more likely to smoke than the general population and are at greater risk of smoking-related illness. Healthcare services need to address this burden of preventable disease.MethodsWe evaluated the impact of a brief intervention that asked service users about smoking when they attended for ambulatory HIV care in London, UK, and offered referral to smoking cessation.ResultsOverall, 1548 HIV-positive individuals were asked about their smoking status over a 12-month period. Of this group, 385 (25%) reported that they were current smokers, 372 (97%) were offered referral to smoking cessation services and 154 (40%) accepted this. We established an outcome of referral for 114 (74%) individuals. A total of 36 (10% of smokers) attended stop smoking clinics and 16 (4%) individuals were recorded as having quit smoking.DiscussionThe simple intervention of asking PLWH about tobacco smoking and offering referral to smoking cessation services rapidly identified current smokers, 40% of whom accepted referral to smoking cessation services. This highlights the importance of promoting behaviour and lifestyle changes with every contact with health services. However, a large proportion of those referred were either not seen in local services or the outcome of referral could not be ascertained. If the risk of smoking-related morbidity among PLWH is to be reduced, more sustainable referral pathways and ways of improving uptake of smoking cessation services must be developed.
Background: Obesity is an increasing problem in England and disproportionately affects those of lower socio-economic status, and there has been a drive for health care professionals at all levels to provide brief advice regarding weight management. There is little evidence on what barriers exist to providing this advice in paediatric settings. Methods: A retrospective review of children’s outpatient clinic notes in a hospital in London, UK during one week was undertaken to collate height and weight measurements and calculate (Body-Mass-Index) BMI centile. Qualitative interviews were conducted with staff to explore attitudes and opportunities to discuss weight Results: Of children included (n=236) Two fifths (41.1%, n=97) had height and weight recorded. BMI centile was calculated for 79.4% of those (n=77). A quarter (26% [95% CI: 13-30%], n=20) were overweight (>91st centile) or obese (>98th centile). Nursing staff reported that the period taking height and weight measurements was not a good opportunity to raise the issue of weight, due to lack of time, lack of knowledge of patient’s medical history and not having BMI centile available. Conclusion: Over one in four children attending the paediatric clinic were overweight or obese. Nursing staff need support and training to feel confident to incorporate discussions around healthy weight into their role and to make the most of opportunities to make every contact count.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.